HIMSS CDS Guidebook Excerpts

The tasks, key lessons, worksheets, and key lessons below are part of the HIMSS CDS Guidebook titled, Improving Outcomes with Clinical Decision Support: An Implementer’s Guide. The information below will help guide you in putting key CDS building blocks in place and establishing an effective CDS knowledge management process.

Chapter 3

Tasks

Systems

  • Prepare an inventory of the information technology assets in your organization relevant to delivering CDS interventions. (Worksheet 3-1)
  • Assess your HIT systems’ CDS capabilities and compatibility with standard vocabularies.
  • Develop a roadmap for acquiring and enhancing information technology systems to meet your organization’s CDS goals.

Workflow

  • Make sure you have the capability to carefully map clinical workflows to be enhanced by CDS—both current and desired future state. (Worksheet 3-2)
  • Think broadly about who are the stakeholders in key workflow processes. Ensure your CDS team has the skills needed to meticulously document what actually happens in these processes through direct observations, instead of relying on interviews and written policies and procedures alone.

Measurement

  • Make sure you have the capabilities and resources for assessing intervention effects as core components of your CDS program. (Worksheets 9-1, 9-3)
  • Align your approach to measuring intervention performance against organizational goals and objectives with broader initiatives to track and improve clinical, operational and financial performance.
  • Leverage CDS governance processes to establish reasonable measurement goals and expectations for improvement.

Key Lessons

Systems

  • Reliable, fast, and usable information technology infrastructure is essential for robust CDS interventions.
  • CDS depends on access to structured (coded) data, use of standard vocabularies, and ability to aggregate information from multiple sources.

Workflows

  • What CDS intervention developers and others think is happening as care processes unfold is often quite different from what is actually happening. Effective CDS interventions require knowledge of the latter, which depends on direct observation supplemented by interviews and other data-gathering tools.

Measurement

  • Many organizations do not allocate enough time or resources to build adequate capability to address CDS intervention effects, but increasing global drivers for measurable healthcare performance improvement make this essential.
  • Appropriately evaluating positive and negative CDS effects requires both quantitative and qualitative approaches.

Worksheets

You can find the corresponding worksheets for this chapter here:

3-1a: CIS Inventory

3-1b: Worksheet 3-1a continued

3-2: Workflow Process Mapping Elements

9-1a: Metric Selection and Use

9-1b: Worksheet 9-1a continued

9-3a: Performance against Objectives

9-3b: Worksheet 9-3a continued

Chapter 3 HIMSS Considerations - Small Practices

Chapter 3 HIMSS Considerations - Vendors

Chapter 4

Tasks

  • Put CDS knowledge management governance structures and processes in place – for example, to make decisions about how you will acquire, monitor and maintain CDS interventions.
  • Use this governance system to create and execute an explicit approach for managing your CDS content portfolio’s life cycle. This includes ensuring that CDS interventions have an appropriate scope to achieve improvement goals, are current with evidence-based best practices and are internally consistent.
  • Catalog your CDS interventions and their key attributes, and use this documentation to monitor and maintain your CDS content portfolio. (Worksheet 4-1)
  • Document important decisions and actions related to managing your CDS intervention assets so that you can build on this learning, and justify knowledge management activities if needed.

Key Lessons

  • A systematic, cyclic process for managing your CDS knowledge assets is essential and includes people, procedures and information systems.
  • Knowledge management activities are an important subcomponent of your CDS program activities, and leverage decision making and management approaches and tools from those broader activities.
  • A knowledge management infrastructure should be established before beginning any CDS implementation.
  • External support for knowledge management activities may be available from vendor personnel or consultants, and should be used to supplement internal staff efforts as needed.

Worksheets

You can find the corresponding worksheet for this chapter here:

4-1: CDS Knowledge Asset Inventory

Chapter 4 HIMSS Considerations - Small Practices

Chapter 4 HIMSS Considerations - Vendors

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